Pocket Reduction Surgery

Pocket reduction surgery is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).

The human mouth contains dozens of different bacteria at any given time. The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.

Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the sub-gingival area (below the gum line). Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed.

Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets and can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.

Pocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth. In some cases, bone can be regenerated around the teeth to result in a shallower pocket without having to induce much recession. The goals of pocket reduction surgery are:

Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke. Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize. It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.Halting bone loss – The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue. As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor. When the teeth become too loose, they may require extraction.
Facilitate home care – As the gum pockets become progressively deeper, they become impossible to clean effectively by the patient. The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.

Pocket Reduction Surgery Q&A

What does pocket reduction surgery involve?

The procedure is performed with local anesthetic. The gums are gently pulled back from the teeth and bacteria and calculus (tartar) will be eliminated. Scaling and root planing will generally be required to fully remove the ossification (tartar) from the surface of the tooth root. If the root is not completely smooth, a planing procedure will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces.

What are some of the side effects of surgery?

There will be recession on the teeth making the teeth appear “taller.” Sensitivity can develop but usually is controlled with regular use of de-sensitizing toothpaste.

What is the recovery time?

Discomfort can be managed with advil and patients are usually fine to return to work after the procedure.

Where is the bone from for Bone Regeneration around teeth?

Bone sources can include: Bovine particles, Allograft particles or Synthetic bone. Your surgeon can make a recommendation on what he feels would work best for your case. These bone particles are often combined with a gel that contain growth factors to encourage healing and/or resorbable membranes. If bone grafting is done, all instrumentation under the gums must be avoided in the area for a minimum of 6 months.